Clin Orthop Surg.  2013 Dec;5(4):314-320. 10.4055/cios.2013.5.4.314.

Treatment Outcomes of Advanced Stage Malignant Melanoma in Hand and Foot after Amputation in Korean Patients

• Cho K
• Jung ST

• KMID: 1787035
• DOI: http://doi.org/10.4055/cios.2013.5.4.314

Abstract

BACKGROUND
A retrospective study was conducted to review the overall survival and treatment outcomes of high grade melanoma in the extremity to explore the clinical features of malignant melanoma of the hand and foot, and the therapeutic efficacies and survival rate after amputation.
METHODS
The clinical data of 30 patients with malignant melanoma of the hand and foot (confirmed by pathological examination), who were admitted and treated in our hospital between 2001 and 2010, were analyzed retrospectively. We analyzed variables affecting overall and disease-free survival.
RESULTS
Thirty patients (18 men and 12 women) treated with an amputation procedure for malignant melanoma in the hand or foot constituted the study cohort. The average age of the patients at the time of diagnosis was 58.7 years. Univariate analysis for overall melanoma survival revealed that diagnosis at over 70 years of age, postoperative lymph node metastasis, and location of the tumor were significant prognostic factors. And on the Kaplan-Meier survival curve, old age, American Joint Committee on Cancer stage and postoperative lymph node metastasis showed statistically significant differences in the 5-year survival rate. Also, amputation with aggressive lymph node dissection showed improved long term survival in advanced stage melanoma.
CONCLUSIONS
In Korean melanoma patients, for the treatment of high grade melanomas in the extremities after amputation, early diagnosis and postoperative follow-up for evaluation of lymph node metastasis are critical factors for long-term survival. And by performing lymph node dissection during amputation, we may improve the survival rate in advanced stage melanoma patients.

Keyword

Melanoma; Amputation; Hand and foot; Advanced stage

MeSH Terms

Aged
*Amputation
Analysis of Variance
Disease-Free Survival
Female
Foot/*surgery
Hand/*surgery
Humans
Kaplan-Meier Estimate
Male
Melanoma/diagnosis/pathology/*surgery
Middle Aged
Neoplasm Staging
Prognosis
Republic of Korea
Retrospective Studies
Skin Neoplasms/diagnosis/pathology/*surgery
Survival Rate
Treatment Outcome

Figure

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  Fig. 1 Percentage of malignant melanomas at each site (n = 30). Lesions were most commonly located either on the sole (20%) or thumb (16.7%).

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  Fig. 2 Kaplan-Meier analysis for overall survival shows long-term survival of 93% at 1 years, 76% at 2 years, and 67% at 5 years.

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  Fig. 3 Graphs show the effect of potential prognostic factors on survival after amputation. Survival curves of patients divided into two groups according to age at diagnosis (A), gender (B), location of the melanoma (C), American Joint Committee on Cancer (AJCC) stage (D), and postoperative lymph node metastasis (E).

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